Diseño de un modelo multiparamétrico de riesgo de eventos microvasculares en el paciente diabético tipo 2 mediante regresión logística múltiple / Design of a multiparametric risk model of microvascular events in the diabetic type 2 patient by means of multiple logistical regression

Propósito del estudio. Diseño de un modelo multiparamétrico de riesgo de eventos microvasculares en el paciente diabético tipo 2 mediante análisis de regresión logística múltiple que permita discriminar las variables asociadas a un mayor riesgo y los individuos más susceptibles de presentar este tipo de complicaciones. Métodos usados. Estudio observacional analítico de 60 diabéticos tipo 2. Muestreo aleatorio sistematizado aplicando un análisis de regresión logística múltiple (programa JMP del SAS Institute).Resultados. Perfil poblacional: edad media: 61,15 ñ 10,69 años; sexo: 36 por ciento hombres/64 por ciento mujeres; índice de masa corporal (IMC): 30,5 ñ 5,03; índice cintura-cadera: 0,97 ñ 0,05; hipertensión arterial: 65 por ciento; sistólica: 143,61ñ16mmHg; diastólica: 83,65 ñ 10,67 mmHg; dislipidemias: 70 por ciento; eventos microvasculares: 35 por ciento; glucemia basal: 174,63 ñ 54,53 mg/dl; HbA1c: 6,56ñ1,61 por ciento; colesterol: 222,61ñ51,37 mg/dl; triglicéridos: 184,93 ñ 15,77 mg/dl; c-HDL: 49,03 ñ 1 mg/dl; microalbuminuria: 16,6 por ciento. Diseño de un modelo de regresión logistica múltiple de eventos microvasculares, análisis de verosimilitud p < 0,0025. Están relacionadas en este modelo las siguientes variables ordenadas según su peso específico en la ecuación de riesgo: microalbuminuria, índice cintura-cadera, hipertensión arterial y glucemia basal. Conclusiones. Se diseña un modelo multiparamétrico de riesgo de eventos microvasculares en el paciente diabético tipo 2 que considera como variables discriminativas asociadas a un mayor riesgo: indice cintura-cadera, hipertensión arterial, microalbuminuria y glucemia basal (AU)

[Chronic metabolic syndrome: a predictive model of risk of macrovascular events?]. / El síndrome metabólico crónico: un modelo predictivo de riesgo de episodios macrovasculares?

OBJECTIVES: To establish a predictive model of the risk of macrovascular complications in patients with Chronic Metabolic Syndrome by means of multiple logistic regression analysis. To identify Chronic Metabolic Syndrome as an independent health problem, given its frequency and importance in the genesis of macrovascular complications. DESIGN: A descriptive observational study. SETTING: An urban Health District in Malaga. PATIENTS: 47 patients with Chronic Metabolic Syndrome were chosen by systematic randomised sampling. MEASUREMENTS AND MAIN RESULTS: The best predictive model of macrovascular events was established as the one which included high values of the Waist-Hip index, blood pressure, Fibrinogenaemia and basal Glucaemia, and low values of HDL cholesterol. CONCLUSIONS: 1. A model to predict macrovascular events in patients with Chronic Metabolic Syndrome included high values of the Waist-Hip index, blood pressure, Fibrinogenaemia and basal Glucaemia, and low values of HDL cholesterol. 2. We believe that this association should be considered an independent health problem on the list of problems, with the name Syndrome X or Chronic Metabolic Syndrome.

Angiotensin I-converting enzyme genotypes and angiotensin II receptors. Response to therapy.

In the present study, we studied angiotensin II type 1 (AT1) and type 2 (AT2) receptor messengers by quantitative reverse transcriptase-polymerase chain reaction. We examined peripheral blood mononuclear cells from 30 healthy subjects and 50 subjects with primary hypertension, in whom angiotensin I-converting enzyme genotype was determined, before and after 15 days of treatment with different antihypertensive drugs. The medication included a calcium channel antagonist, an angiotensin I-converting enzyme inhibitor, and a beta 1-blocker. We also studied the relationship between AT1 receptor gene expression and biochemical parameters of the renin-angiotensin system. AT1 receptor messenger levels were positively correlated with plasma renin activity in both normotensive and untreated hypertensive subjects. Increases of this messenger and plasma angiotensin II levels were correlated with the D allele in the same individuals. AT1 receptor messenger levels decreased significantly with angiotensin I-converting enzyme inhibitor treatment in subjects with the DD genotype, and a significant decrease was observed in subjects with the II and ID genotypes treated with a calcium antagonist. No changes were observed in mRNA with the beta 1-blocker. We conclude that the AT2 receptor is not expressed in peripheral leukocytes and that AT1 receptor messenger levels vary in relation to angiotensin I-converting enzyme genotype and pharmacological treatment. These results suggest that angiotensin I-converting enzyme genotype may be an important factor when deciding on antihypertensive therapy in individuals with primary hypertension.

Direct quantification of HIV-1 RNA in human plasma by free solution capillary electrophoresis (FSCE).

SUMMARY: The levels of human immunodeficiency virus type 1 (HIV-1) RNA have been directly quantitated, after an isolation step, in plasma from patients with primary HIV-1 infection by free solution capillary electrophoresis (FSCE) with ultraviolet detection. HIV-1 RNA was detected and quantified at physiological levels by measuring the absorbance by FSCE. All the patients with primary infection showed concentrations in a range of 1.08-1.71 x 10(8) virions/ml of plasma. No signals were observed in seronegative donors. This procedure represents a practical alternative to other methods to quantify HIV-1 RNA and may be useful in assessing the efficiency of antiretroviral agents, especially during the early stage when other conventional viral markers are often negative.